Risk factors for hydrocephalus after periventricular-intraventricular hemorrhages in premature infants

Abstract

Objective To study the risk factors for secondary hydrocephalus after periventricular-intraventricular hemorrhage(PVH-IVH)in premature infants. Methods From Jun.2007 to Jun.2012, 214 premature infants who were admitted to the Neonatal Intensive Care Unit after birth were enrolled and head ultrasonography showed PVH-IVH from 3 to 7 days after birth.They were classified into PVH-IVH alone group (n=161) and secondary hydrocephalus after PVH-IVH group (n=53) based on the different prognosis.Single factor and multivariate Logistic regression analysis were used to identify risk factors for secondary hydrocephalus after PVH-IVH. Results Single analysis indicated 8 factors associated with hydrocephalus after PVH-IVH, including male, gestational age <28 weeks, birth weight <1000 g, severe asphyxia, PVH-IVH Ⅲ or Ⅳ, metabolic acidosis, hyponatremia, and hypoglycemia or hyperglycemia (all P<0.05); multivariate Logistic regression analysis showed that male (OR=3.317), severe asphyxia (OR=13.838), PVH-IVH ⅢorⅣ(OR=43.281), and hyponatremia (OR=2.731) were independent risk factors for hydrocephalus after PVH-IVH (all P<0.05 ). Conclusions Male, severe asphyxia, PVH-IVH Ⅲ or Ⅳ, and hyponatremia are closely related to hydrocephalus after PVH-IVH in preterm infants.After PVH-IVH, these clinical risk factors should be followed closely in the prevention of hydrocephalus. Key words: Periventricular-intraventricular hemorrhage; Hydrocephalus; Risk factor; Premature infant